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Food Allergy versus Food Intolerance - do you know the difference?

Food allergy versus food intolerance


Some of the symptoms of food intolerance and food allergy are similar, but the differences between the two are very important.  If your child were to eat a food that they were intolerant to, they would be left feeling miserable.  However, if your child has a true food allergy, their body’s reaction to this food could be life threatening.  There is much misunderstanding about these terms and they are frequently confused. Many people speak of food allergy when what they describe is likely to be food intolerance. 

For parents with children with food allergies, potential dangers lurk in every facet of their normal, everyday life.  Deciphering a food allergy from food intolerance early on in your child’s life is important. 

The digestive system versus the immune system – the first step in understanding.

What is food intolerance?
A food intolerance response takes place in the digestive system.  It is a rather slow onset reaction, hours, days or even weeks.  It occurs when you are unable to properly breakdown the food.  This could be due to a number of reasons:

1. Sensitivity to food additives,
2. Reactions to naturally occurring chemicals in foods or,  Wheat.jpg
3. Enzyme deficiencies

Enzyme deficiencies can manifest in two ways. 

(i) Firstly children can be born with the inability of not being able to produce the appropriate enzymes for normal breakdown or,

(ii) Secondly an enzyme deficiency caused by restricting a particular food for a significant amount of time and then consuming a large volume in one sitting.  For example removing cow's milk from your child’s diet for a couple of months and then giving them a large milkshake as an afternoon treat.  Because their body has not had to process milk for so long the particular enzyme becomes out of practice and does not know how to handle or process this sudden large volume it is presented with.  Often, people can eat small amounts of these foods without causing problems if they are consumed regularly as part of a normal diet. 
If you have removed a suspected food from your child's diet remember to reintroduce it back slowly and in small volumes.  This will be the best way to see if their body is able to process this food efficiently. 

Symptoms of food intolerance are much more delayed, less dramatic and lifestyle threatening rather than life threatening. They generally manifest as nutritional deficiencies that develop over time.

What is food allergy?
An allergic reaction involves the immune system – a fast (minutes) response by your body to a particular food.  Your immune system controls how your body defends itself to a perceived invader.  For example if you have an allergy to cow’s milk, your immune system identifies cow’s milk as an invader or allergen.  Your immune system reacts by producing Peanuts.jpgsubstances called antiobodies (IgE).  These antibodies travel to cells in the body that release certain chemicals, causing an allergic reaction.  Each type of antibody has a specific ‘radar’ for each type of allergen (i.e. milk has a different one to wheat which has again a different one to eggs and so it goes on). 

Unlike an intolerance to food, a food allergy can cause a serious or even life-threatening reaction by eating a microscopic amount, touching or even inhaling the food. 
Did you know?
Most children outgrow egg, milk, soy and wheat allergies.  But peanut, tree nut, fish and shellfish allergies tend to be lifelong.

Your immune system signs or symptoms are typically immediate, dramatic and visible as they are generally seen on the skin (hives, itchiness, swelling of the skin).  Gastrointestinal symptoms may include vomiting and diarrhea.  Respiratory symptoms (coughing, wheezing) may accompany skin and gastrointestinal symptoms, but don’t usually occur alone. 

Anaphalaxis (pronounced an-a-fi-LAK-sis) is a serious allergic reaction that happens very quickly.  Symptoms of anaphylaxis may include difficulty breathing, dizziness or loss of consciousness.  Without immediate treatment it can be fatal. 

How do I find out if my child if affected by a food allergy or food intolerance?
There are many allergy tests out there, some of which are very expensive.  If you have an allergy, the only accurate form of diagnosis is in a medical setting using a skin prick test or blood allergy test to detect allergen-specific antibodies called IgE. There are several other types of tests available but according to the Australasian Society of Clinical Immunology and Allergy (ASCIA), these are based on limited evidence and are not recommended.  If you have an intolerance, the only accurate way to pinpoint the offending food is to follow an elimination diet. 

Elimination diets
Testing for food intolerance means carefully eliminating all possible suspects from your child’s diet and then adding them back one at a time to check for reactions.  There are no simple tests that can be done.  It can take months, but improving your child’s symptoms will be worth the effort.  Following this food elimination diet means severely restricting the foods you eat.  Growing children need to eat from a wide range of food groups.  Unnecessarily restricting their diet could be harmful to their normal growth and development.  For these reasons it is important that you get expert guidance to help you manage your child’s diet and systematically work through the process.  Consult a specialist in this area. 
Don’t try and keep track of your child’s daily diet in your head…it is impossible to remember what you have eaten in a day let alone your child.  Keep a food diary.  You will find that it will be far more accurate.

When to see an allergist?
• If you think your child might have a food allergy.
• If you have limited your diet based on possible food allergy.
• For the best diagnosis, as well as treatment and avoidance measures for food allergy.

In next months Yum Yum Kids feature article we will delve into this issue of food allergies more deeply.  How many children in New Zealand suffer from food allergies, is it on the rise and how does it develop. 

To read more Yum Yum Kids articles click here or to view some of our great new products available to make eating fun click here.

Australasian Society of Clinical Immunology and Allergy (ASCIA).
Choice. 2009. Food allergies and intolerances.
David TJ. 2000. Adverse reactions and intolerance to foods. British Medical Journal 56:34-50
Kemp AS. Food allergy in children. Aust Fam Physician 1993; 22(11):1959-633
A First Guide to Food Allergy. 2003. Allergy New Zealand Inc.
Allergy New Zealand Education kit for schools and preschools. 2006. Allergy New Zealand Inc.